Localized Mesothelioma Successfully Treated with Chemotherapy and Surgery

A patient with a rare, localized malignant pleural mesothelioma has been successfully treated. The patient received chemotherapy and surgery and has been disease-free for 12 months. Many believe that a localized form of pleural mesothelioma might have a better survival outlook. This is compared with patients who have the more common, diffuse variety.

This latest report comes from a Japanese team of thoracic surgeons.

Local vs. Diffuse Mesothelioma

Malignant mesothelioma is a rare cancer affecting an estimated 2,500 Americans annually. All forms of mesothelioma have been linked to asbestos exposure. Malignant pleural mesothelioma is the most common form of malignant mesothelioma.

Most pleural mesothelioma patients have a type of cancer that tends to spread quickly. It spreds across the thin membrane that surrounds the lungs. Patients with localized malignant mesothelioma have identical cancer cells. But the growth pattern is different. Instead of spreading across the lungs, localized mesothelioma is a solid tumor in one location.

The World Health Organization has recently classified these two different types. The “diffuse malignant mesothelioma” is the more common type of mesothelioma. The newly termed “localized malignant mesothelioma” is more rare. Only 0.5% to 1.6% of patients have a localized malignant pleural mesothelioma.

Little is known about localized malignant mesothelioma or about its treatment strategy.

Successful Treatment of Localized Cancer

A new report tells the story of a localized malignant pleural mesothelioma patient who was successfully treated.

The story starts when a 63-year-old man walks into a hospital with a cough. He had been working as an electrical engineer for 45 years with a history of exposure to asbestos. The chest X-ray, CT, and MRI scans all showed a tumor.

A CT-guided biopsy was performed. And immunohistochemistry of the biopsy and antibody tests confirmed mesothelioma. The patient was diagnosed with a localized malignant pleural mesothelioma.

He started with four cycles of chemotherapy with cisplatin and pemetrexed on day 1 every 3 weeks. A post-chemotherapy CT scan showed a good reduction in the size of the tumor. The chemotherapy was working and showed significant tumor shrinkage.

The patient also received surgery. Four weeks after the chemotherapy, the patient underwent surgery via a median sternotomy. This surgery is considered the standard of care. He was able to leave the hospital 15 days after surgery without any complications.

The patient has now been disease-free for 12 months.

Localized malignant mesothelioma is related to asbestos exposure. The rate of malignant mesothelioma is increasing worldwide because of a history of asbestos use. This history suggests that localized malignant mesothelioma may increase in the future.

Chemotherapy followed by surgery could be a standard treatment for localized malignant mesothelioma.

Source:

Maki, Yuho, Yosuke Kiriyama, Tsuyoshi Ueno, Hiroshi Suehisa, Hisayuki Shigematsu, Kazuhiko Saeki, Daijiro Harada, Toshiyuki Kozuki, Norihiro Teramoto, and Motohiro Yamashita. “A Case of Mediastinal Localized Malignant Pleural Mesothelioma Successfully Treated by Chemotherapy and Conversion Surgery.” Acta Medica Okayama 76, no. 3 (2022): 343-347. https://ousar.lib.okayama-u.ac.jp/en/63746